How much rates vary
Facilitymedian $3,236 · 10th to 90th $2,188 to $6,310Professionalmedian $933 · 10th to 90th $661 to $1,660
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $741.31 | Professional | None | $575.44 | $741.31 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,659.59 | Professional | None | $891.25 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,737.80 Typical High $2,511.89 | Professional | 50 · Both sides | $1,148.15 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $186.21 Typical High $269.15 | Professional | 80 · Assistant surgeon | $123.03 | $186.21 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $162.18 Typical High $234.42 | Professional | AS · PA/NP assist | $107.15 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $3,981.07 | Facility | None | $812.83 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,905.46 | Professional | None | $758.58 | $912.01 | $1,905.46 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,819.70 | Professional | None | $616.60 | $933.25 | $1,819.70 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | None | $758.58 | $891.25 | $1,513.56 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $512.86 |
Where New Hampshire sits
The same service costs 4.0 times more in Wisconsin than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
WI $7,647MT $1,932
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.